Health Equity Learning Community

We have an ethical responsibility to follow through for infants and families.

Social determinants

We must learn to practice social medicine, not just technical medicine.

Health and well being are largely determined by race, ethnicity, income, immigration status, and local neighborhood. The effects are pronounced for infants in NICU care.

There is much that we can and must do to address the social determinants of health.

VON’s Health Equity Learning Community is dedicated to follow through to address the social determinants of health with the same energy and expertise that we devote to the technical aspects of care.

Upcoming Webinar: Health Equity in the Age of Covid

Potentially Better Practices

The list of 68 Potentially Better Practices for Follow Through from Vermont Oxford Network is intended as a starting point for individuals and teams.

We refer to improvement ideas as Potentially Better Practices rather than “better” or “best” practices to indicate that no practice is better or best until adapted, tested and shown to work in the local context.

The PBPs are divided into four main categories:

  • Promote a culture of equity
  • Identify social risks of families and provide interventions to prevent and mitigate those risks
    • Take action to assist families after discharge (transition to home)
    • Maintain support for families through infancy
  • Develop robust quality improvement efforts to ensure equitable, high-quality hospital and follow through care to all newborns by eliminating modifiable disparities
  • Advocate for social justice at the local, state, and national levels

See all Potential Better Practices in Our Responsibility to Follow Through for NICU Infants and their Families (Pediatrics, June 2020).

2019 Annual Quality Congress

Health Equity at the Annual Quality Congress

Our “Color of Health” sessions from the 2019 Annual Quality Congress are available on the VON Improvement Library.

Related Research

Beck AF, Edwards EM, Horbar JD, Howell EA, McCormick MC, Pursley DM. The color of health: how racism, segregation, and inequality affect the health and well-being of preterm infants and their families. Pediatr Res. 2019; epub ahead of print. PubMed: 31357209Open access.

Horbar JD, Edwards EM, Greenberg LT, Profit J, Draper D, Helkey D, Lorch SA, Lee HC, Phibbs CS, Rogowski J, Gould JB, Firebaugh G. Racial segregation and inequality in the neonatal intensive care unit for very low-birth-weight and very preterm infants. JAMA Pediatr. 2019; epub ahead of print. PubMed: 30907924

Boghossian NS, Geraci M, Lorch SA, Phibbs CS, Edwards EM, Horbar JD. Racial and ethnic differences over time in outcomes of infants born less than 30 weeks’ gestation. Pediatrics. 2019 Aug 12; epub ahead of print. PubMed: 31405887.

Parker MG, Greenberg LT, Edwards EM, Ehret D, Belfort MB, Horbar JD. National trends in the provision of human milk at hospital discharge among very low-birth-weight infants. JAMA Pediatr. 2019 Sept 3; epub ahead of print. PubMed: 31479097.

Sigurdson K, Morton C, Mitchell B, Profit J. Disparities in NICU quality of care: a qualitative study of family and clinician accounts. J Perinatol. 2018;38(5):600-607. PubMed: 29622778

Lake ET, Staiger D, Edwards EM, Smith JG, Rogowski JA. Nursing care disparities in neonatal intensive care units. Health Services Research. 2017 Sept 14; Epub ahead of print. PubMed: 28905367

Lake ET, Staiger D, Horbar J, Kenny MJ, Patrick T, Rogowski JA. Disparities in perinatal quality outcomes for very low birth weight infants in neonatal intensive care. Health Serv Res. 2015;50(2):374-397. PubMed: 25250882

Morales LS, Staiger DO, Horbar JD, Carpenter J, Kenny M, Geppert J, Rogowski J. Mortality among very low birthweight infants in hospitals serving minority population. Am J Public Health. 2005;95(12): 2206-2212. PubMed: 16304133